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Changes in Economic Status of Households Associated with Catastrophic Health Expenditures for Cancer in South Korea

  • Choi, Jae-Woo ;
  • Cho, Kyoung-Hee ;
  • Choi, Young ;
  • Han, Kyu-Tae ;
  • Kwon, Jeoung-A ;
  • Park, Eun-Cheol
  • Published : 2014.03.30

Abstract

Background: Cancer imposes significant economic challenges for individuals, families, and society. Households of cancer patients often experience income loss due to change in job status and/or excessive medical expenses. Thus, we examined whether changes in economic status for such households is affected by catastrophic health expenditures. Materials and Methods: We used the Korea Health Panel Survey (KHPS) Panel $1^{st}-4^{th}$ (2008-2011 subjects) data and extracted records from 211 out of 5,332 households in the database for this study. To identify factors associated with catastrophic health expenditures and, in particular, to examine the relationship between change in economic status and catastrophic health expenditures, we conducted a generalized linear model analysis. Results: Among 211 households with cancer patients, 84 (39.8%) experienced catastrophic health expenditures, while 127 (40.2%) did not show evidence of catastrophic medical costs. If a change in economic status results from a change in job status for head of household (job loss), these households are more likely to incur catastrophic health expenditure than households who have not experienced a change in job status (odds ratios (ORs)=2.17, 2.63, respectively). A comparison between households with a newly-diagnosed patient versus households with patients having lived with cancer for one or two years, showed the longer patients had cancer, the more likely their households incurred catastrophic medical costs (OR=1.78, 1.36, respectively). Conclusions: Change in economic status of households in which the cancer patient was the head of household was associated with a greater likelihood that the household would incur catastrophic health costs. It is imperative that the Korean government connect health and labor policies in order to develop economic programs to assist households with cancer patients.

Keywords

Job status;cancer;household;catastrophic health expenditure;Korea

References

  1. Aguiar M (2005). Consumption versus expenditure. Journal of Political Economy, 113, 919-48. https://doi.org/10.1086/491590
  2. Bukki J, Klein J, But L, et al (2013). Methicillin-resistant staphylococcus aureus (MRSA) management in palliative care units and hospices in Germany: a nationwide survey on patient isolation policies and quality of life. Palliat Med, 27, 84-90. https://doi.org/10.1177/0269216311425709
  3. Chirikos TN, Russell-Jacobs A, Cantor AB (2002). Indirect economic effects of long-term breast cancer survival. Cancer Pract, 10, 248-55. https://doi.org/10.1046/j.1523-5394.2002.105004.x
  4. Cho KH, Park S, Lee KS, et al (2013). A single measure of cancer burden in Korea from 1999 to 2010. Asian Pac J Cancer Prev, 14, 5249-55. https://doi.org/10.7314/APJCP.2013.14.9.5249
  5. Choi JG (2012). Impacts of the benefit extension policy on financial burden and catastrophic health care expenditure. Korean J Health Economics Policy, 18, 19.
  6. Dybicz SB, Thompson S, Molotsky S, Stuart B (2011). Prevalence of diabetes and the burden of comorbid conditions among elderly nursing home residents. Am J Geriatr Pharmacother, 9, 212-23. https://doi.org/10.1016/j.amjopharm.2011.05.001
  7. Phipps MS, Desai RA, Wira C, Bravata DM (2011). Epidemiology and outcomes of fever burden among patients with acute ischemic stroke. Stroke, 42, 3357-62. https://doi.org/10.1161/STROKEAHA.111.621425
  8. Xu K, Evans DB, Kadama P, et al (2006). Understanding the impact of eliminating user fees: utilization and catastrophic health expenditures in Uganda. Soc Sci Med, 62, 866-76. https://doi.org/10.1016/j.socscimed.2005.07.004
  9. Xu K, Evans DB, Kawabata K, et al (2003). Household catastrophic health expenditure: a multicountry analysis. Lancet, 362, 111-7. https://doi.org/10.1016/S0140-6736(03)13861-5
  10. Park JH, Park EC, Park JH, et al (2008). Job loss and reemployment of cancer patients in Korean employees: a nationwide retrospective cohort study. J Clin Oncol, 26, 1302-9. https://doi.org/10.1200/JCO.2007.14.2984
  11. Longo CJ, Fitch M, Deber RB, Williams AP (2006). Financial and family burden associated with cancer treatment in Ontario, Canada. Support Care Cancer, 14, 1077-85. https://doi.org/10.1007/s00520-006-0088-8
  12. Pantilat SZ, Kerr KM, Billings JA, et al (2012). Characteristics of palliative care consultation services in California hospitals. J Palliat Med, 15, 555-60. https://doi.org/10.1089/jpm.2011.0390
  13. Park JH, Lee KS, Choi KS (2013). Burden of cancer in Korea during 2000-2020. Cancer Epidemiol, 37, 353-9. https://doi.org/10.1016/j.canep.2013.03.015
  14. Song EC, Shin YJ (2010). The effect of catastrophic health expenditure on the transition to poverty and the persistence of poverty in South Korea. J Prev Med Public Health, 43, 423-35 (in Korean). https://doi.org/10.3961/jpmph.2010.43.5.423
  15. Stommel M, Given CW, Given BA (1993). The cost of cancer home care to families. Cancer, 71, 1867-74. https://doi.org/10.1002/1097-0142(19930301)71:5<1867::AID-CNCR2820710525>3.0.CO;2-7
  16. Su TT, Kouyate B, Flessa S (2006). Catastrophic household expenditure for health care in a low-income society: a study from nouna district, burkina Faso. Bull World Health Organ, 84, 21-7.
  17. Wagstaff A (2007). The economic consequences of health shocks: evidence from Vietnam. J Health Econ, 26, 82-100. https://doi.org/10.1016/j.jhealeco.2006.07.001
  18. Wagstaff A, van Doorslaer E (2003). Catastrophe and impoverishment in paying for health care: with applications to Vietnam 1993-1998. Health Econ, 12, 921-34. https://doi.org/10.1002/hec.776
  19. Wyszewianski L (1986). Families with catastrophic health care expenditures. Health Serv Res, 21, 617-34.
  20. Guidry JJ, Aday LA, Zhang D, Winn RJ (1998). Cost considerations as potential barriers to cancer treatment. Cancer Pract, 6, 182-7. https://doi.org/10.1046/j.1523-5394.1998.006003182.x
  21. Fairfield KM, Murray KM, Wierman HR, et al (2012). Disparities in hospice care among older women dying with ovarian cancer. Gynecol Oncol, 125, 14-8. https://doi.org/10.1016/j.ygyno.2011.11.041
  22. Houts PS, Lipton A, Harvey HA, et al (1984). Nonmedical costs to patients and their families associated with outpatient chemotherapy. Cancer, 53, 2388-92. https://doi.org/10.1002/1097-0142(19840601)53:11<2388::AID-CNCR2820531103>3.0.CO;2-A
  23. Flannelly KJ, Emanuel LL, Handzo GF, et al (2012). A national study of chaplaincy services and end-of-life outcomes. BMC Palliat Care, 11, 10. https://doi.org/10.1186/1472-684X-11-10
  24. Kang MS, Jang HS, Lee M, Park EC (2012). Sustainability of Korean national health insurance. J Korean Med Sci, 27, 21-4. https://doi.org/10.3346/jkms.2012.27.S.S21
  25. Kang TW (2009). Analysis of private health insurance on catastrophic health expenditure of household with cancer patient. Graduate School of Public Health, Seoul National University.
  26. Kavosi Z, Rashidian A, Pourreza A, et al (2012). Inequality in household catastrophic health care expenditure in a lowincome society of Iran. Health Policy Plan, 27, 613-23. https://doi.org/10.1093/heapol/czs001
  27. Kim CB (2002). A Care Condition of Cancer Patients In Health Insurance. Korea National Health Insurance Service.
  28. Kim SY, Chang YJ, Do YR, et al (2013). Employment status and work-related difficulties among family members of terminally ill patients compared with the general population. Asian Pac J Cancer Prev, 14, 373-80. https://doi.org/10.7314/APJCP.2013.14.1.373
  29. Kim SY, Kim SG, Park JH, Park EC (2009). Costs of initial cancer care and its affecting factors. J Prev Med Public Health, 42, 243-50. https://doi.org/10.3961/jpmph.2009.42.4.243
  30. Lauzier S, Maunsell E, Drolet M, et al (2008). Wage losses in the year after breast cancer: extent and determinants among Canadian women. J Natl Cancer Inst, 100, 321-32. https://doi.org/10.1093/jnci/djn028

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